Underbite Causes, Symptoms, and Treatment Options

An underbite is a type of bite misalignment in which the lower front teeth sit in front of the upper front teeth when the mouth is closed. Dentists may refer to this condition as a Class III malocclusion.

Some underbites are caused mainly by the position of the teeth, while others develop because the upper and lower jaws have grown at different rates. The type and severity of the underbite help determine which treatment options may be appropriate.

Although an underbite can affect the appearance of the smile and facial profile, it may also interfere with chewing, speaking, jaw comfort, and long-term oral health.

Concerned about your bite or your child’s jaw development? Schedule an evaluation with Premier Family Dental or call (480) 279-5611 to discuss the next steps.

What Does an Underbite Look and Feel Like?

The most recognizable sign of an underbite is that the lower front teeth extend beyond the upper front teeth. In mild cases, the difference may be subtle. More significant underbites may cause the lower jaw or chin to appear more prominent.

Other possible signs and symptoms include:

• Difficulty biting or chewing certain foods
• Speech changes or difficulty pronouncing some sounds
• Uneven or excessive tooth wear
• Jaw discomfort or facial muscle fatigue
• Teeth grinding or clenching
• Difficulty bringing the lips together comfortably
• Headaches or discomfort near the jaw joints
• Lower front teeth that noticeably overlap the upper teeth

Not everyone with an underbite experiences pain or functional problems. However, even a painless bite misalignment should be evaluated so that a dentist can determine whether it may affect the teeth, gums, or jaw over time.

What Causes an Underbite?

An underbite may develop because of dental alignment, jaw development, or a combination of both. Genetics is one of the most common contributing factors, particularly when similar jaw or bite patterns occur among family members.

Potential causes and contributing factors include:

• Inherited differences in jaw size or facial development
• A lower jaw that has grown farther forward than the upper jaw
• An upper jaw that has not developed far enough forward
• Lower teeth that tilt outward toward the lips
• Upper teeth that tilt inward toward the tongue
• Crowded, missing, or unusually positioned teeth
• Prolonged thumb-sucking or pacifier use during childhood
• Tongue-thrusting habits
• Facial trauma or a jaw injury that healed improperly
• Certain developmental or craniofacial conditions

An underbite caused mainly by tooth position is known as a dental underbite. An underbite caused by differences in jaw growth is considered skeletal. A dental examination and appropriate imaging are necessary to distinguish between the two.

Can an Underbite Affect Your Oral Health?

An underbite is not always merely a cosmetic concern. When the upper and lower teeth do not meet correctly, pressure may be distributed unevenly across the bite.

Over time, an untreated underbite may contribute to:

• Premature enamel wear
• Chipped, cracked, or sensitive teeth
• Difficulty chewing food efficiently
• Speech difficulties
• Jaw pain or muscle tension
• Stress on the temporomandibular joints
• Difficulty cleaning crowded or overlapping teeth
• An increased risk of tooth decay or gum problems

The American Association of Orthodontists explains that bite problems can affect chewing, speech, tooth wear, and jaw comfort. The effects vary, so treatment recommendations should be based on an individual evaluation rather than appearance alone.

If your teeth do not meet comfortably or you have noticed changes in your child’s bite, request an appointment with our Gilbert dental team. You may also call (480) 279-5611 for assistance.

How Is an Underbite Diagnosed?

Diagnosing an underbite begins with an examination of the teeth, bite, jaw movement, and facial proportions. The dentist may ask about chewing difficulties, speech concerns, jaw discomfort, childhood oral habits, previous injuries, and family history.

Dental X-rays, photographs, impressions, or digital scans may also be used to evaluate tooth position and jaw development. These findings help determine whether the underbite is primarily dental, skeletal, or a combination of both.

Depending on the diagnosis, the dentist may recommend monitoring the bite, beginning treatment, or coordinating care with an orthodontist or oral and maxillofacial surgeon.

What Are the Treatment Options for an Underbite?

Underbite treatment depends on the patient’s age, the severity of the misalignment, the condition of the teeth and gums, and whether the problem involves the teeth, jawbones, or both.

Not every underbite requires the same approach. Mild cases may need limited orthodontic treatment, while significant skeletal underbites may require coordinated orthodontic and surgical care.

Braces

Traditional braces can move the teeth into improved positions and correct many dental underbites. Braces may also be used before or after jaw surgery when both the teeth and jaws require correction.

The treatment plan may include brackets, wires, elastics, and retainers. Treatment time varies according to the complexity of the bite and how the teeth respond.

Clear Aligners

Clear aligners may help correct certain mild or moderate underbites caused mainly by tooth position. They gradually move selected teeth using a planned series of removable trays.

Clear aligners cannot correct every underbite, especially when a significant difference in jaw size or position is involved. An in-person examination is essential before determining whether aligners are appropriate.

The American Dental Association’s guide to orthodontics, braces, and aligners explains how orthodontic appliances guide teeth into healthier positions.

Growth-Guidance Appliances for Children

Because a child’s jaws are still developing, early treatment may provide options that are no longer available after growth is complete.

Depending on the cause of the underbite, an orthodontist may recommend an upper-jaw expander, reverse-pull headgear, or another growth-guidance appliance. These devices are intended to influence jaw development and improve the relationship between the upper and lower jaws.

The American Association of Orthodontists’ underbite guidance explains that growth-guiding treatment may be helpful for some children whose underbite is related to jaw development.

Tooth Extraction

Tooth extraction may be incorporated into treatment when severe crowding or limited space prevents the teeth from being aligned properly. However, removing teeth does not automatically cause the jaw to relax or return to a different position.

Extractions are recommended only after evaluating the bite, facial profile, available space, and overall orthodontic plan. Orthodontic treatment is usually needed afterward to move the remaining teeth into their planned positions.

Restorative or Cosmetic Treatment

Minor tooth reshaping, bonding, crowns, or veneers may improve the appearance of carefully selected mild cases. These treatments change the shape or appearance of teeth but do not correct a significant skeletal jaw discrepancy.

Restorative treatment should not be used to disguise an underbite without first evaluating how the proposed changes could affect the bite and remaining tooth structure.

Corrective Jaw Surgery

Corrective jaw surgery, also called orthognathic surgery, may be recommended for adults with a moderate or severe skeletal underbite. Surgery may reposition the upper jaw, lower jaw, or both so they fit together more appropriately.

Orthodontic treatment is commonly completed before and after surgery to align the teeth with their new jaw positions. Surgery is generally reserved for cases that cannot be adequately corrected through tooth movement alone.

Underbite Treatment for Children Versus Adults

The primary difference between treating children and adults is jaw growth.

In children, an orthodontist may be able to guide the growth of the jaws while the bones are still developing. Early intervention does not always eliminate the need for future treatment, but it may reduce the severity of the problem or simplify later care.

The American Association of Orthodontists recommends that children receive an orthodontic evaluation by age seven. This does not mean every child will need braces at that age. It allows developing bite problems to be identified and monitored at an appropriate time.

Adults can still receive successful underbite treatment. However, because adult jaw growth is complete, significant skeletal underbites are more likely to require a combination of orthodontics and corrective jaw surgery.

Can an Underbite Be Fixed Without Surgery?

Some underbites can be treated without surgery, particularly when the misalignment is mild, primarily dental, or identified while a child is still growing.

Possible nonsurgical treatments include:

• Braces
• Clear aligners for selected cases
• Orthodontic elastics
• Upper-jaw expansion
• Reverse-pull headgear
• Other growth-guidance appliances

A pronounced skeletal underbite in an adult usually cannot be fully corrected by moving the teeth alone. Attempting to camouflage a severe jaw discrepancy may create an unstable bite or move teeth beyond healthy limits.

Can an Underbite Correct Itself?

An established underbite is unlikely to correct itself without professional care. Jaw growth during childhood can make the condition more or less noticeable, but waiting for it to disappear may allow the misalignment to become more difficult to manage.

An early evaluation helps determine whether treatment should begin promptly or whether the bite can be monitored as the child grows.

Does an Underbite Get Worse With Age?

Some underbites become more pronounced as the lower jaw continues to grow during childhood and adolescence. Adults may also notice worsening tooth wear, gum problems, jaw tension, or chewing difficulties even after jaw growth has stopped.

The progression depends on the cause and severity of the underbite. Regular dental examinations allow changes in the bite and tooth wear to be monitored.

How Long Does Underbite Treatment Take?

Treatment may take several months to several years. The timeline depends on the patient’s age, treatment method, severity of the underbite, jaw growth, and whether surgery is required.

A mild dental underbite may respond to orthodontic treatment sooner than a complex skeletal underbite. Patients who need jaw surgery generally complete orthodontic treatment both before and after the procedure.

Is Underbite Treatment Painful?

Orthodontic appliances can cause temporary pressure or tenderness when they are first placed or adjusted. This discomfort usually improves as the mouth adapts.

Corrective jaw surgery involves a more significant recovery period. The oral surgeon will provide instructions for managing swelling, discomfort, diet, and healing after the procedure.

When Should You See a Dentist About an Underbite?

Schedule an evaluation if you notice that your lower teeth sit in front of your upper teeth, your bite feels uncomfortable, or you experience difficulty chewing or speaking.

Parents should also arrange an assessment when a child’s lower jaw appears increasingly prominent or the front teeth meet in an unusual way. Early evaluation can help determine whether the bite should be monitored or treated while the jaws are still developing.

The Cleveland Clinic’s medically reviewed underbite resource provides additional information about underbite symptoms, possible complications, and common treatments.

Get Your Bite Evaluated in Gilbert, Arizona

The appropriate treatment for an underbite depends on more than how the smile looks. A careful examination is needed to evaluate tooth position, jaw development, bite function, and oral health.

Premier Family Dental provides patient-focused general dentistry in Gilbert for children and adults. Our team can evaluate your bite, explain the findings, and coordinate additional orthodontic or surgical care when necessary.

Request an appointment with Premier Family Dental or call (480) 279-5611 to speak with our team.

Learn more about our approach to care by visiting the Premier Family Dental homepage, reviewing our answers to common dental questions, or taking a moment to meet the dental professionals who will care for your smile.

You can also view Premier Family Dental’s Gilbert location and patient reviews on Google before your visit.